Clinical Practice Guidelines
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Clinical Practice Guidelines, published by HL7 International / Clinical Decision Support. This guide is not an authorized publication; it is the continuous build for version 3.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/cqf-recommendations/ and changes regularly. See the Directory of published versions

PlanDefinition: CKD Ambulatory Plan Definition (Experimental)

Official URL: http://hl7.org/fhir/uv/cpg/PlanDefinition/cc-cpg-plan-ckd Version: 3.0.0-ballot
Active as of 2026-11-10 Computable Name: ChronicKidneyDiseaseAmbulatory
Other Identifiers: OID:2.16.840.1.113883.4.642.40.48.34.21

Usage: Clinical Focus: Chronic kidney disease (disorder)

Copyright/Legal: Copyright © Elsevier, and others.

Chronic Kidney Disease - Ambulatory

Metadata
Version 3.0.0-ballot
Identifier urn:oid:2.16.840.1.113883.4.642.40.48.34.21
Experimental true
Use Context Clinical Focus = Chronic kidney disease (disorder)
Jurisdiction World
Topic Treatment
Steward (Publisher) HL7 International / Clinical Decision Support
Steward Contact HL7 International / Clinical Decision Support
Description

Chronic Kidney Disease - Ambulatory
Copyright

Copyright © Elsevier, and others.
Type Order Set
PlanDefinition Action
Id cc-cpg-activity-referral-nephrology
Title Referrals
Grouping Behavior Visual Group
PlanDefinition Sub-Action (Parent Action ID: cc-cpg-activity-referral-nephrology)
Id 34387224
Title Referral: Nephrology; History: [add diagnosis, symptom(s)]; Question: [add reason for referral]
Description Referrals
Required Behavior Could
Pre-check Behavior No
Definition ReferralNephrology
PlanDefinition Sub-Action
Id 34387224
Title Referral: Nephrology; History: [add diagnosis, symptom(s)]; Question: [add reason for referral]
Description Referrals
Required Behavior Could
Pre-check Behavior No
Definition ReferralNephrology
PlanDefinition Sub-Action (Parent Action ID: cc-cpg-activity-referral-nephrology)
Id cc-cpg-activity-referral-dietition
Title Referral: Dietitian; History: chronic kidney disease; Question: [add reason for referral]
Description Referrals
Required Behavior Could
Pre-check Behavior No
Definition ReferralDietitian
PlanDefinition Sub-Action
Id cc-cpg-activity-referral-dietition
Title Referral: Dietitian; History: chronic kidney disease; Question: [add reason for referral]
Description Referrals
Required Behavior Could
Pre-check Behavior No
Definition ReferralDietitian
Citations and References
Justification Description: SYNOPSIS - Chronic Kidney Disease KEY POINTS Decline in function of the kidney characterized by at least 3 months of reduced GFR (less than 60 mL/minute/ 1.73 m²) or at least 3 months of structural or functional kidney damage Assessment of both GFR and albuminuria is necessary to diagnose chronic kidney disease and monitor disease progression GFR is most commonly estimated through measuring serum creatinine and the use of GFR estimating equations, either the Modification of Diet in Renal Disease Study equation or the Chronic Kidney Disease Epidemiology Collaboration equation Albuminuria is measured by urine albumin/creatinine ratio; greater than 30 mg/g indicates albuminuria Chronic kidney disease is commonly associated with hypertension, diabetes, and cardiovascular disease First line therapy includes ACE inhibitors and/or angiotensin II receptor blockers to reduce albuminuria and hypertension If left untreated, chronic kidney disease can progress to end-stage renal disease requiring dialysis or renal transplant Symptoms of end-stage renal disease (eg, pruritus, refractory electrolyte imbalances, metabolic acidosis, severe nausea, neurologic impairments) typically occur when GFR is 5 to 10 mL/minute/1.73 m² Carefully monitor electrolyte levels, hemoglobin, parathyroid hormone levels, and sodium bicarbonate levels to detect complications of chronic kidney disease, including cardiovascular disease, anemia, bone mineral disease, and metabolic acidosis URGENT ACTION Hyperkalemia may require urgent treatment in patients being treated for chronic kidney disease Urgent treatment consists of calcium chloride or calcium gluconate and regimens of sodium bicarbonate, glucose and insulin, or nebulized albuterol PITFALLS Early stages are often asymptomatic, causing chronic kidney disease to be untreated, leading to further progression of kidney damage and worse prognosis
Citation:

Chronic Kidney Disease Clinical Overview. ClinicalKey. Source

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